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Trends in pediatric epilepsy surgery in Europe between 2008 and 2015: Country‐, center‐, and age‐specific variation
Author(s) -
Barba Carmen,
Cross Judith Helen,
Braun Kees,
Cossu Massimo,
Klotz Kerstin Alexandra,
De Masi Salvatore,
Perez Jiménez Maria Angeles,
Gaily Eija,
Specchio Nicola,
Cabral Pedro,
Toulouse Joseph,
Dimova Petia,
Battaglia Domenica,
Freri Elena,
Consales Alessandro,
Cesaroni Elisabetta,
TartaArsene Oana,
GilNagel Antonio,
Mindruta Ioana,
Di Gennaro Giancarlo,
Giulioni Marco,
Tisdall Martin M.,
Eltze Christin,
Tahir Muhammad Zubair,
Jansen Floor,
van Rijen Peter,
Sanders Maurits,
Tassi Laura,
Francione Stefano,
Lo Russo Giorgio,
Jacobs Julia,
Bast Thomas,
Matta Giulia,
Budke Marcelo,
Fournier del Castillo Concepción,
Metsahonkala EevaLiisa,
Karppinen Atte,
Ferreira José Carlos,
Minkin Krasimir,
Marras Carlo Efisio,
Arzimanoglou Alexis,
Guerrini Renzo
Publication year - 2020
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16414
Subject(s) - epilepsy , epilepsy surgery , medicine , partial epilepsy , scars , pediatrics , retrospective cohort study , magnetic resonance imaging , multivariate analysis , surgery , radiology , psychiatry
Objective To profile European trends in pediatric epilepsy surgery (<16 years of age) between 2008 and 2015. Methods We collected information on volumes and types of surgery, pathology, and seizure outcome from 20 recognized epilepsy surgery reference centers in 10 European countries. Results We analyzed retrospective aggregate data on 1859 operations. The proportion of surgeries significantly increased over time ( P < .0001). Engel class I outcome was achieved in 69.3% of children, with no significant improvement between 2008 and 2015. The proportion of histopathological findings consistent with glial scars significantly increased between the ages of 7 and 16 years ( P for trend = .0033), whereas that of the remaining pathologies did not vary across ages. A significant increase in unilobar extratemporal surgeries ( P for trend = .0047) and a significant decrease in unilobar temporal surgeries ( P for trend = .0030) were observed between 2008 and 2015. Conversely, the proportion of multilobar surgeries and unrevealing magnetic resonance imaging cases remained unchanged. Invasive investigations significantly increased, especially stereo‐electroencephalography. We found different trends comparing centers starting their activity in the 1990s to those whose programs were developed in the past decade. Multivariate analysis revealed a significant variability of the proportion of the different pathologies and surgical approaches across countries, centers, and age groups between 2008 and 2015. Significance Between 2008 and 2015, we observed a significant increase in the volume of pediatric epilepsy surgeries, stability in the proportion of Engel class I outcomes, and a modest increment in complexity of the procedures.